Hiroyuki Yamaoka

Matrilysin is associated with progression of colorectal tumor

Matrilysin and gelatinase A, B mRNA expressions were examined in colorectal tumors. Matrilysin mRNA was observed exclusively in tumors, while the others were also found in normal mucosa surrounding tumors. Further analysis revealed that colorectal adenomas with severe dysplasia, not with mild dysplasia, expressed matrilysin with lower levels than cancers. The level of matrilysin mRNA expression increased with the advancement of stages of colorectal cancers, consequently a relatively higher expression was observed in liver metastatic tumors than primary tumors. These results suggest that matrilysin mRNA expression was correlated with the progression of colorectal tumors, and this enzyme may also play a role in developing metastatic tumors in liver.

Micrometastatic colorectal cancer lesions in the liver

A surgical resection of metastatic liver lesions from colorectal cancer contributes to an improved prognosis. However, the postoperative recurrence rate remains high, particularly in the residual liver. This is probably the result of the failure to detect small lesions. In the present study, we histologically examined the presence of intrahepatic micrometastases, which are considered to be related to recurrence in the residual liver. Intrahepatic micrometastases were histologically examined in 31 resected specimens of 25 patients undergoing a hepatic resection because of metastasis to the liver from colorectal cancer. Micrometastases were found in 14 of 25 cases (56.0%). They were located in the portal veins, central veins, sinusoid, and bile ducts. The longest distance from the main metastasis was 38.2 (mean 7.5±8.0) mm. The size of the macrometastases became larger, and the frequency of micrometastases and the distance of micrometastases from macrometastases had a tendency to increase. Continuous invasion of the macrometastases into the micrometastases through the vasculature or bile duct was also observed. These results suggested that some micrometastases observed in the metastatic liver from colorectal cancer were thus seeded from the primary lesions, while other micrometastases originated from the macrometastatic lesions as satellite lesions.

Postoperative chemotherapy including intraperitoneal and intradermal administration of the streptococcal preparation OK-432 for patients with gastric cancer and peritoneal dissemination : a prospective randomized study

We studied the effects on survival time of postoperative immuno-chemotherapy, including the streptococcal preparation OK-432, in patients with gastric cancer and synchronous peritoneal dissemination. The patients were prospectively randomized and a valid statistical assessment could be made for 109. Patients randomized to group B received therapy that is widely used in Japan to treat patients with gastric cancer: mitomycin C (MMC) and UFT, a combination of tegafur and uracil in a molar ratio of 1∶4, for 1 year. Patients randomized to group A received the same drugs as were given to group B patients plus OK-432 i.p. for 7 days, beginning on postoperative day 0, and OK-432 by intradermal injection for 1 year, at 2-week intervals. There were no differences between the two groups in any known prognostic factor or in the dose of any drug administered except for OK-432. There was no difference in the toxicity rate between the groups. In this negative trial, there was no improvement in survival time with the addition of OK-432 to MMC and UFT for patients with gastric cancer and peritoneal dissemination.

Extramedullary Plasmacytoma of the Breast with Serum IgD Monoclonal Protein: A Case Report and Review of the Literature.

A case of extramedullary plasmacytoma (EMP) of the breast in a 49-year-old woman is reported. Six cases of EMP of the breast have been previously reported in the world literature, but this case is unusual in that it was associated with serum IgD lamda monoclonal protein detected by serum immunoelectrophoresis. The protein was identical to the immunoprotein found in proliferating cells of the breast. Bone marrow aspiration revealed normal plasma cells indicating that the breast tumor did not represent extramedullary involvement of multiple myeloma or myelomatosis. An associated tumor was found in the nasal cavity after local treatment (mastectomy) of the breast tumor, but the patient remained disease-free 12 months after adjuvant chemotherapy using nidlan, natulan, alkelan, prednisone, cyclophosphamide and vincristine.

The Value of Microvessels in the Tumor of Gastric Carcinoma

33 patients with gasric carcinoma were studied to examine the relationship between the micrvessel count and their histological findings or prognosis.Microvessels were identified by staining their endotherial cells for factor VIII-related antigen with use of a standard immunoperoxidase technique and counted per 200x field.The mean microvessel count was 39.1±28.6. The microvessel count was being higher according to tumor growth and occurence of lymphnode metastasis.Borrmann4 type and poorly differentiated adenocarcinoma had high microvessel count.But themicrovessel count was not correlated with the site of recurrence or prognosis of gastric carcinoma.

Clinical studies on recurrence of colorectal cancer.

大腸癌根治手術後の再発の防止および早期発見による治療成績の向上を目的として治癒手術後3年以上経過例における再発について検討を行った. 再発は415例中145例 (34.9%) にみられ約80%は2年以内, 約90%は3年以内にみられた. 再発形式は結腸癌では肝再発が半数をしめ, 直腸癌では局所再発が最も高頻度であった. 再発後5年生存例は3例のみであり, 再発死亡例129例の平均生存期間は11.6ヵ月であった. carcinoembryonic antigen, computed tomographyの導入により特に肝再発の切除率の向上がみられ, 再発巣の切除により生存期間が延長したと考えられる症例もあり, 腫瘍マーカー測定や画像診断などによる定期的なフォローアップを行い早期に再発を診断することが重要であると考えられた.